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    Prescribing an antibiotic?

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    Abstract

    When you prescribe antibiotics, tell patients that taking probiotics for the entire course of treatment will help prevent diarrhea.

    PRACTICE CHANGER

    Recommend that patients taking antibiotics also take probiotics, which have been found to be effective both for the prevention and treatment of antibiotic-associated diarrhea (AAD).1

    STRENGTH OF RECOMMENDATION

    A: Based on a systematic review and meta-analysis of randomized controlled trials.

    Hempel S, Newberry S, Maher A, et al.

    Probiotics for the prevention and treatment of antibiotic-associated diarrhea. JAMA. 2012;307: 1959-1969.

    ILLUSTRATIVE CASE

    When you prescribe an antibiotic for a 45-year-old patient with Helicobacter pylori, he worries that the medication will cause diarrhea.

    Should you recommend that he take probiotics?

    More than a third of patients taking antibiotics develop AAD,2 and in 17% of cases, AAD is fatal.3,4 Although the diarrhea may be the result of increased gastrointestinal (GI) motility in some cases, a disruption of the G

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